Prayers

Not long ago a man holidaying with his family falls suddenly to the floor, crying to his little boy as he falls, Call an ambulance! The man does not speak again. He lies in a coma in the Intensive Care Unit of a little hospital in Bali, with injuries to his brain that can’t be measured or treated properly there.

 

 

Around the bedside of the man his mother and his 10 year-old son and his elder sister stand and try to understand. A mother looks at her only son; a sister, burdened by her knowledge of the brain, gazes at her wounded brother.  The sister’s husband grips her hand. The boy who gave the man his chance of life sees his father, inert, intubated, silent. The child has no language, no words, in his world overturned.

 

 

The mother, the sister, the child speak – when they can bring forth words from their grief – soft, urgent  murmurs of love. The brother in law breathes his prayers.

 

 

The man is surrounded by love and tears. Does he hear the murmured prayers of his loved ones? Will he learn one day of the care and the grief of his many, many friends?

 

 

An aircraft is sent from Australia to retrieve the man, to bring him home, to get the most advanced care. The plane is an airborne ICU with the super-nurse and the intensivist doctor who can keep the injured man safe as he crosses half a world.

 

 

All of this will be hideously expensive. The insurer pauses, ponders, plays for time as time races. How much time does the  wounded man have? The wounded man lies outside time, while his loved ones, their desperation growing, plan to fund the costs privately. 

 

 

 

The man flies home and is admitted to the excellent hospital. The family scrambles for flights, eventually rejoining the man who does not speak.

 

 

 

After all their frantic haste the family falls now into a world of no haste, a world of deliberate care. No idle speech. Words of yearning love whispered into the ears of the stricken. The words spoken aloud are the necessary words of critical work, as gauges flash, tubes drip, drip, drip and respirators observe their slow rhythm of rise and fall.

 

 

All wait.

 

 

Many come, the aunt, the man’s friends from today, and from all his yesterdays, stretching back to early boyhood. Solemnity sits heavily upon them.

 

The man Raj, has a wide, wide smile. He has innumerable anguished friends and a family – to which I belong: Raj is my daughter-in-law’s brother, her younger brother who, from earliest times, she lived to protect. Sister and brother planned this holiday time together, with their spouses and children.

The sister landed in Bali only to learn that Raj had fallen, and had undergone emergency surgery that same morning.

 

In all the deliberating silence doctors search the damage. An early image unveils the haemorrhage-surge that tore through the delicate brain. Later tests answer the question we dread to ask: when stimulated, the unliving brain shows no response.

No flicker, no spark.

 

 

The brain subsists in its inscrutable dark. We in our world of talk and think and act, exist utterly separated from Raj. We are exiles from Raj’s new world.

 

 

 

Raj has known this world before. Before his birth, before his conception, Raj existed as thought, as hope, as desire. This world lacked Raj. When he came into being, Raj was answer to prayer, he completed a world.

 

 

Now Raj and we inhabit worlds distinct, we with memory, with yearning, and with lack.

 

 

Raj’s world is eternal, ours ephemeral. Confined here for our instant of being, we know nothing of eternity. From that place where Raj now abides for all time, time itself is exiled, together with pain.

 

 

Who knows, but perhaps prayer lingers there, together with love?

 

 

 

What does it all mean? Part 1

We’ve rushed here today, to the Operating Theatre. During this Rotation we are to follow the surgeons wherever their work takes them.
A couple of weeks ago the young surgeon whispered: Don’t rush home this evening, Howard. Something’s going to happen,
something historic. I didn’t rush home and history did happen – Australia’s first heart transplantation. A few of us stood outside Theatre and waited. Somehow it didn’t feel anticlimactic to miss the experience, to stand adjacent as history happened. We sensed the meaning.

This afternoon the call came: Emergency surgery in Theatre. Come now!
The boy on the table was riding his bike home from school when he was hit. He wasn’t too bad at first but then his blood pressure fell,
and his heart started to race. His skin colour turned to parchment and his belly began to swell. His trolley bursts into Theatre and the Surgeon’s Apprentice begins to cut into the distended belly without waiting for anaesthesia: the boy had been deeply unconscious since he arrived in the ambulance. The Chief arrives, flings on gown and gloves, no time to wash, takes over the operation. A mild man of about sixty, wise, he’s not reflective now as he slashes the belly widely open and a tide of blood pours over both surgeons, onto the floor.
Suction!
Artery forceps!
Artery forceps!
Artery forceps!
Frantic action above the table, quick mopping at the feet of the surgeons, lest they slip and fall.
The tide of blood does not abate.
No speech, nothing heard apart from fast movement of limbs as they grope and suck and search slippery viscera for the bleeder.
Artery forceps grab suspect bleeding sources but the flood does not slow.
The blood they are transfusing is insufficient.
More blood!
A second transfusion starts.
The anaesthetist’s voice says, we’ve lost the heartbeat. There’s no blood pressure.
The surgeon works by feel beneath the surface, groping, hoping, grasping at straws for the unseen splenic pedicle.
The anaesthetist injects adrenaline, massages the heart.
He looks at the boy’s pupils. They’ve dilated. He shines a light to see if the pupils will shrink by reflex. He’s searching for vitality of a brain that’s had no supply of blood – for how long?
Too long. The reflex is absent. He leans over the boy’s pale face to his colleague and taps him on the arm: He’s gone. We’ve lost him.

All this took place in 1967. I don’t remember feeling stricken. Was I numb perhaps, with horror? With self-terror? I caught the event but I missed the meaning.
The boy was twelve years old. His hair was fair and he was lightly freckled. Today he’d be old enough for the pension. I feel stricken now. Riding my bike – yes, a bike: the connection passes me by – riding to the shops this morning, I feel the enormity and my feet fail on the pedals.

(This is the first in a series in which this old doctor recalls and reflects and wonders.)